Benefit Appeals Report

OMB 1205-0172

OMB 1205-0172

The ETA 5130, Benefit Appeals Report, contains information on the number of appeals and the resultant decisions classified by program, appeal level, cases filed and disposed of (workload flow), and decisions by level, appellant and issue. The data on this form are used to monitor the benefit appeals process in the state workforce agencies (SWAs). Data are also used for budgeting and workload data.

The latest form for Benefit Appeals Report expires 2023-06-30 and can be found here.

All Historical Document Collections
Approved with change
Extension without change of a currently approved collection 2023-05-12
Approved without change
Extension without change of a currently approved collection 2020-05-18
Approved without change
Revision of a currently approved collection 2017-02-06
Approved with change
Extension without change of a currently approved collection 2014-01-22
Approved without change
Extension without change of a currently approved collection 2010-11-30
Approved without change
Extension without change of a currently approved collection 2007-10-09
Approved without change
Extension without change of a currently approved collection 2004-10-18
Approved without change
Extension without change of a currently approved collection 2001-08-16
Approved without change
Extension without change of a currently approved collection 1998-08-17
Approved without change
Revision of a currently approved collection 1995-06-27
Approved without change
Extension without change of a currently approved collection 1992-06-22
Approved without change
Extension without change of a currently approved collection 1989-06-27
Approved without change
Extension without change of a currently approved collection 1987-08-18
Approved without change
Extension without change of a currently approved collection 1986-06-03
Approved without change
Reinstatement with change of a previously approved collection 1984-01-17
Approved without change
New collection (Request for a new OMB Control Number) 1981-10-30
OMB Details

Benefit Appeals Report (ETA 5130 REG)

Federal Enterprise Architecture: Income Security - Unemployment Compensation

Form ETA 5130BENEFIT APPEALS REPORTFillable FileableForm and instruction

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.


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